Caracterização das práticas de assistência na rede de atenção em saúde mental: revisão integrativa

Abstract

This study is an integrative literature review that aims to identify and analyze the characteristics of assistance practices in mental health Primary Health Care in Brazil. The sample consisted in nine articles, from databases consulted in the period between 2001 and 2009. In data analyses, results were grouped in two themes: activities and principles of psychiatric reform. Results show that even when the substitute services adopt some activities/ principles from psychiatric reform, yet there is a valorization of physician-focused activities, which lead to a persistence of the old paradigms and practices. The multidisciplinary team of mental health, needs to restructure its assistance and its knowledge, so that practices focused on the principles of psychiatric reform can be permanent.Descriptors: Mental health. Health care reform. Nursing. RESUMO Este estudo é uma revisão integrativa, com objetivo de identificar e analisar as características das práticas de assistência na

O papel da atenção primária de saúde na constituição das redes de cuidado em saúde mental The role of primary attention in health on the constitution of the network care in mental health

“…These group activities should be done in an organized way, with pre-defined objectives, with the theme according to the reality of the community and often, since they are closely linked to one of the main objectives of the psychiatric reform that is the biopsychosocial rehabilitation. 2 The matriciation strategy becomes important in this scenario, since the participation of mental health professionals in the primary care professionals in these groups, in a joint coordination, facilitates the learning of the FHS professionals regarding the management of the subjective aspects of the group process, to whom these professionals often feel insecure. 4 Nursing appointments and home visits are also important in the development of mental health care.…”

“…Home visits are a practice in which professionals have the possibility to work in the adjoining territory with the user, establishing a link between the health team and the community, as well as allowing professionals to identify the risk and vulnerability of these people. 2 However, the interview of professionals interviewed did not describe the home visit of professionals of higher level, only the visit of the Community Health Agent (ACS).…”

“…[19][20] FHS professionals work with listening and dialogue when users bring their problems from their homes, such as crises and stresses that they face in everyday life and that are affecting the quality of life. 2 The professionals interviewed report that the relationship with the CAPS is more focused on the reference of the users with more severe disorders, but recently, there were meetings so that the CAPS professionals can help in the treatment of the users treated in the FHT, through therapeutic groups directed for these users.…”

“…21 Among the principles for the organization of substitutive mental health services, it is necessary to point out the essential shift from the perspective of the intervention of psychiatric hospitals to the community; The displacement of the center of interest only from the disease to the subject in psychological distress and to their social disability and the displacement of an individual action to a collective action in the confrontations of the users with their contexts. 2 In the speeches of the professionals and users interviewed it is possible to perceive the great importance given to the medical treatment, the main report when speaking about practices of Care is the reference to the consultations with the psychiatrist and the use of the medicine. Discontinuation of drug treatment is considered to be one of the triggering factors for outbreaks.…”

“…1 The Psychosocial Care Center (CAPS) is considered a strategic device for the organization of RAPS, since it is responsible for articulating all levels of care and for supervising mental health care in basic care, being able, thus, to promote integrality in mental health actions to users in psychological distress, in addition to enabling better flow and care. 2 Among the services included in RAPS, the Family Health Strategy (FHS), as a community service that is closer to family and communities, focused on popular participation and the promotion of self-care, has become essential for the integration between the mental disorder patient, multiprofessional team, family and community in psychosocial rehabilitation, attending to the subject in all its aspects, guaranteeing the full and possible exercise of their citizenship. 3 CAPS have great importance in taking care of people with mental disorders, because these health services are designed to meet the needs of people with mental disorders, especially severe and persistent disorders in their territory, ensuring a warm environment through the presence of responsible and trained professionals during the whole period of unit operation.…”